Provider Demographics
NPI:1952408247
Name:KYAW, MYA (MD)
Entity Type:Individual
Prefix:
First Name:MYA
Middle Name:
Last Name:KYAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 ENBORG CT UNIT 400
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2644
Mailing Address - Country:US
Mailing Address - Phone:408-885-6140
Mailing Address - Fax:
Practice Address - Street 1:820 ENBORG CT UNIT 400
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2644
Practice Address - Country:US
Practice Address - Phone:408-885-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA883262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA88326OtherLICENSE
CABK7411325OtherDEA
CACA911RMedicare PIN
CACA911TMedicare PIN
CACA911IMedicare PIN
CACA911JMedicare PIN
CACA911MMedicare PIN
CACA911NMedicare PIN
CACA911UMedicare PIN
CACA911HMedicare PIN
CABK7411325OtherDEA
CACA911LMedicare PIN
CACA911ZMedicare PIN
CACA911OMedicare PIN